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Individual

CHRISTINA RODRIGUEZ JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1777 NORTHEAST EXPY NE STE 120, BROOKHAVEN, GA 30329-2475
(404) 228-8558
(404) 228-8659
Mailing address
1777 NORTHEAST EXPY NE STE 120, BROOKHAVEN, GA 30329-2475
(404) 228-8558
(404) 228-8659

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009728
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14087060
ASHA LICENSE
Enumeration date
09/04/2019
Last updated
09/04/2019
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